SynthesisPloS one2020
Effectiveness of implementing a decentralized delivery of hepatitis C virus treatment with direct-acting antivirals: A systematic review with meta-analysis.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Acceptability and Effectiveness of Point-of-Care HCV Testing in Low- and Middle-Income Countries: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- Feasibility of a prison-based test-and-treat model for enhancing hepatitis C care in Kedah, Malaysia.BMC public health · 2025Article
- Subspecialty physicians' perspectives on barriers and facilitators of hepatitis C treatment: a qualitative study.Harm reduction journal · 2024Article
- An algorithm for simplified hepatitis C virus treatment with non-specialist care based on nation-wide data from Taiwan.Hepatology international · 2024Observational
- Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs.Harm reduction journal · 2023Article
- Nurse-led initiation of hepatitis C care in rural Cambodia.Bulletin of the World Health Organization · 2023Article
- Patients' access to and acceptance of community-based hepatitis C testing and treatment in Myanmar: A mixed-method study.PLOS global public health · 2023Article
- Article
- Diagnostic performance of two non-invasive biomarkers used individually and in sequential combination for cirrhosis associated with hepatitis C virus infection.Scientific reports · 2022Article
- Developing a primary care-initiated hepatitis C treatment pathway in Scotland: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Outcomes of the CT2 study: A 'one-stop-shop' for community-based hepatitis C testing and treatment in Yangon, Myanmar.Liver international : official journal of the International Association for the Study of the Liver · 2021Article
- "Stigma is where the harm comes from": Exploring expectations and lived experiences of hepatitis C virus post-treatment trajectories among people who inject drugs.The International journal on drug policy · 2021Article
- Hepatitis C virus in India: Challenges and Successes.Clinical liver disease · 2021Review
- Effectiveness of a Decentralized Hub and Spoke Model for the Treatment of Hepatitis C Virus in a Federally Qualified Health Center.Hepatology communications · 2021Article
- Hepatitis C (HCV) therapy for HCV mono-infected and HIV-HCV co-infected individuals living in Nepal.PLoS neglected tropical diseases · 2020Article
- The direct-medical costs associated with interferon-based treatment for Hepatitis C in Vietnam.Wellcome open research · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Direct-acting agents (DAAs) for hepatitis C virus (HCV) treatment are safe and highly effective. Few studies described the sustained virologic response rates of treatment conducted by non-specialists. We performed a systematic review and meta-analysis to evaluate the effectiveness of decentralized strategies of HCV treatment with DAAs. PubMed, Embase, Scopus and LILACS were searched until March-2019. Studies were screened by two researchers according to the following inclusion criteria: HCV treatment using DAAs on real-life cohort studies or clinical trials conducted by non-specialized health personnel. The primary endpoint was the sustained virologic response rate at week 12 after the end-of-treatment (SVR12), which is binary at the patient level. Data were extracted in duplicate using electronic-forms and quality appraisal was performed with the NIH Quality Assessment Tool. Heterogeneity was assessed by I2 statistics. Random-effects meta-analysis models were used for pooling SVR12 rates. Publication bias was assessed using funnel plots. Among the 130 selected studies, nine papers were included for quantitative synthesis. The quality-appraisal was good for two, fair for three and poor for four studies. The pooled relative risk (RR) of SVR12 was not statistically different between decentralized strategy and treatment by specialists [RR = 1.05; 95% confidence interval (95% CI): 0.98-1.1; I2 = 45% (95% CI: 0-84%), p = 0.145]. SVR12 rate for decentralized HCV treatment was 81% [SVR12 95% CI: 72-89%; I2 = 93% (95% CI: 88-96%)] and 95% [SVR12 95%CI: 92-98%; I2 = 77% (95% CI: 52-89%)] with intention to treat analysis and per-protocol analysis, respectively. SVR12 rates using DAAs managed by non-specialized health personnel were satisfactory and similar to those obtained by specialists. This new delivery strategy can improve access to HCV treatment, especially in resource-limited settings. PROSPERO #: CRD42019122609.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.